Fortmann S P, Taylor C B, Flora J A, Jatulis D E
Center for Research in Disease Prevention, Stanford University School of Medicine, Palo Alto, CA 94304-1885.
Am J Epidemiol. 1993 Jan 1;137(1):82-96. doi: 10.1093/oxfordjournals.aje.a116605.
To determine the effects of 5 years of community-wide cardiovascular health education on smoking prevalence and cessation, the authors analyzed data from the Stanford Five-City Project, an experimental field study with two treatment cities and two control cities. Representative samples of the population aged 12-74 years were drawn at baseline and every 2 years thereafter to obtain four independent cross-sectional surveys; participants aged 25-74 years are included in this paper (n approximately 440 per city per survey; total n = 6,981). The baseline sample was asked to return to three follow-up surveys, also 2 years apart, and those that did (n = 805) constitute the cohort survey sample. Self-reported cigarette smoking was confirmed by plasma thiocyanate and expired-air carbon monoxide levels. Smoking prevalence decreased over time in all cities, but in the cohort the decrease tended to be greater in treatment than in control cities (p = 0.10, two-tailed); the treatment-control difference was consistent over time (-1.51 percentage points/year in treatment vs. -0.78 percentage points/year in control, p = 0.007, two-tailed). In contrast, smoking prevalence in the independent samples declined similarly in treatment and control cities, changes were not linear, and rates varied within cities between times. Baseline smokers in both the cohort and the follow-up independent surveys were significantly more likely to quit in the treatment cities than in the control cities.
为了确定为期5年的社区范围心血管健康教育对吸烟率及戒烟的影响，作者分析了来自斯坦福五城市项目的数据，这是一项有两个治疗城市和两个对照城市的实验性现场研究。在基线期及之后每两年抽取12 - 74岁人群的代表性样本，以获得四次独立的横断面调查；本文纳入了25 - 74岁的参与者（每个城市每次调查约440人；总计n = 6,981）。基线样本被要求返回参加同样间隔两年的三次随访调查，实际返回的那些人（n = 805）构成队列调查样本。通过血浆硫氰酸盐和呼出气体一氧化碳水平来确认自我报告的吸烟情况。所有城市的吸烟率均随时间下降，但在队列中，治疗城市的下降幅度往往大于对照城市（p = 0.10，双侧）；治疗组与对照组的差异随时间保持一致（治疗组每年下降1.51个百分点，对照组每年下降0.78个百分点，p = 0.007，双侧）。相比之下，在独立样本中，治疗城市和对照城市的吸烟率下降情况相似，变化并非呈线性，且不同城市在不同时间的下降率有所不同。队列调查和随访独立调查中的基线吸烟者在治疗城市比在对照城市更有可能戒烟。
